Healthcare Provider Details

I. General information

NPI: 1477564011
Provider Name (Legal Business Name): ALFRED J WROBLEWSKI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W MITCHELL ST STE 4
PETOSKEY MI
49770-2214
US

IV. Provider business mailing address

630 W MITCHELL ST STE 4
PETOSKEY MI
49770-2214
US

V. Phone/Fax

Practice location:
  • Phone: 231-348-4005
  • Fax: 833-973-5899
Mailing address:
  • Phone: 231-348-4005
  • Fax: 833-973-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number069568
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY GAYE WROBLEWSKI
Title or Position: ADMINISTRATOR
Credential:
Phone: 231-348-4005